Open AccessUse of Guideline‐Recommended Therapies for Heart Failure in the Medicare Population
Author(s) -
DiMartino Lisa D.,
Shea Alisa M.,
Hernandez Adrian F.,
Curtis Lesley H.
Publication year - 2010
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.20760
Subject(s) - medicine , guideline , medical prescription , heart failure , medicare part d , prescription drug , logistic regression , population , medicaid , emergency medicine , cohort , intensive care medicine , pharmacology , environmental health , health care , pathology , economics , economic growth
Background Most information about the use of guideline‐recommended therapies for heart failure reflects what occurred at discharge after an inpatient stay. Hypothesis Using a nationally representative, community‐dwelling sample of elderly Medicare beneficiaries, we examined how the use of angiotensin‐converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and β‐blockers has changed and factors associated with their use. Methods Using data from the Medicare Current Beneficiary Survey cost and use files matched with Medicare claims data, we identified beneficiaries for whom a diagnosis of heart failure was reported between January 1, 2000, and December 31, 2004. Data on medications prescribed during the year of cohort entry were based on patient self‐report. We used multivariable logistic regression to explore relationships between the use of ACE inhibitors/ARBs and β‐blockers and patient demographic characteristics. Results From 2000 through 2004, the use of ARBs increased from 12% to 19%, and the use of β‐blockers increased from 30% to 41%. The use of ACE inhibitors remained constant at 45%. Beneficiaries who reported having prescription drug insurance coverage were 32% more likely than other beneficiaries to have filled a prescription for an ACE inhibitor or ARB and 26% more likely to have filled a prescription for a β‐blocker. Conclusions Although the use of guideline‐recommended therapies for heart failure has increased, it remains suboptimal. Copyright © 2010 Wiley Periodicals, Inc.